For many, watching a loved one age is a difficult process. It’s hard to identify whether that person is receiving the proper care from the right physician.
Dr. Michael Roizen, chief wellness officer for the Cleveland Clinic, spoke to HealthScene Ohio and offered some words of wisdom on aging patients’ needs.
HealthScene Ohio: There are plenty of conditions that hamper people as they age. What seems to be the most problem-causing and widespread complaint?
Dr. Michael Roizen: Aging patients fear memory loss, breaking a hip or being relatively immobile from arthritis. Before retirement, they worry about running out of money.
In my experience, the greatest physical problem is heart disease from arterial aging. Most patients don’t think about that as a concern since it is a lifestyle disease. I tell them there are six choices people can make that decrease chronic disease 80 to 90 percent, and it is never too late to start them. The six goals are a normal waist-to-height ratio, normal fasting blood sugar, normal low-density lipoprotein, blood pressure, stress management twice a day whether or not you feel as though you need it, and avoiding tobacco and unhealthy diets.
Also, you can take 900 milligrams of docosahexaenoic acid, an omega-3 fatty acid, and play speed and processing games, which decreases dementia by 45 percent and decreases injury from auto accidents by 48 percent.
HSO: What is the ultimate goal when taking care of elderly patients?
MR: To help the person get where they want to be. To help them live longer without running out of money, breaking a hip or becoming forgetful. We want to get the person where they believe they want to go.
HSO: In your biography, it says you encourage your patients to be courageous. What does that mean?
MR: They have got to start getting healthier. Many of them have been sedentary or have eaten the typical American diet and have done relatively unhealthy things for a large number of years. They need to be courageous and tell themselves, “I am going to do things differently.”
HSO: What does the RealAge metric consist of? How was it formulated and how does it help patients?
MR: It represents the net present value of all of the health choices you make. RealAge is the actual age of your body instead of your calendar age. It is more accurate than many other similar techniques.
HSO: How do you coach patients struggling with unhealthy life decisions such as smoking?
MR: Find out what motivates them, and do a daily email coaching with patients to get them to the point where they see their goals. They bond with a coach, and the project is asynchronous so they can send an email anytime. We have automated processes that help us. It is easy enough for anyone to use. The current regimen consists of six months for weight loss, elevated blood pressure, hypertension and hyperlipidemia, and seven months for breaking addictions such as tobacco. These have shown to be very successful, as there is a 63 percent, seven-month success rate with tobacco cessation; a 1.1-pound loss a week for weight loss in men; and an 0.8-pound a week loss for the first 26 weeks in women. Additionally, about 50 percent of these patients get rid of metabolic syndrome within the first year.
HSO: Though the changes sound simple, lifestyle change can be overwhelming. How do you help motivate them to make the change?
MR: Every living person has the potential to make changes. Your job as a physician is to find the passion that drives a person and to use it to motivate them. That’s the fun of it. It’s a real joy to get to motivate people. When they deviate from the program – and everyone will stop at one time or another, it’s typical – your job is to act quickly and correct their behavior. It’s a tough love approach, but it’s my job to remind them of that.
HSO: What are some tips when trying to make a lifestyle change in diet?
MR: Avoid the “five food felons” and make food taste as great as you can. You want to have a relationship with food. You want to love the food you eat and you want it to love you back. The five food felons include simple sugars, syrups, non-whole grains, and foods with saturated fats and trans fats.
HSO: Caring for aging relatives can be tough on families. What advice do you give the sons, daughters, grandchildren, etc. as they go through the process of providing care for their aging family members?
MR: Get help. No one can do this alone, and you should involve the whole family rather than do it alone. It normally falls on the oldest female child, but that person has to do a sharing of the care.
David Allen is a contributing writer. Feedback welcome atfeedback@cityscenemediagroup.com.
Dr. Michael F. Roizen
Dr. Michael F. Roizen is a Phi Beta Kappa graduate of Williams College and Alpha Omega Alpha graduate of the University of California, San Francisco School of Medicine. Roizen is a past Chair of a Food and Drug Administration advisory committee and a former editor for six medical journals. He is one of the co-founders of the website RealAge.com. In 2007, Roizen was named chief wellness officer at Cleveland Clinic. Roizen also serves as Chairman of the Wellness Institute at Cleveland Clinic.
5 Things Health Care Providers and Patients Should Question
Courtesy of the American Geriatrics Society
- Whether to use a feeding tube in patients with advanced dementia rather than oral-assisted feeding. Tube feeding can be associated with agitation or increased use of physical or chemical restraints.
- Treating behavioral and psychological symptoms of dementia with antipsychotics as a first choice — his presents increased risks in oversedation as well as falls and strokes.
- Achieving hemoglobin A1c 7.5 percent with medication in most adults age 65 and older – moderate control is better. Glycemic targets should reflect patient goals, health status and life expectancy.
- Using benzodiazepines or other sedative-hypnotics in older adults as the first choice for insomnia, agitation or delirium. Studies show the risk of car accidents, hip fractures and fall leading to hospitalization and sometimes even death can more than double in older adults taking benzodiazepines and other sedative-hypnotics.
- Using antimicrobials to treat bacteriuria in older adults, unless specific urinary tract symptoms are present. Antimicrobial treatment studies show no benefits, but do show increased adverse antimicrobial effects.
